Mental Health: Compassion Fatigue & Self-Care Practices

By Jennifer Alumbaugh, LMFT

“Compassion Fatigue is a state experienced by those helping people or animals in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper.” ~ Dr. Charles Figley

heart handWe’ve all had our experiences with being stressed out—feeling overwhelmed at the end of a long day or a trying week full of deadlines and intense interactions with others. Usually a good night’s rest or a day or two off are enough to recuperate from stress. When that stress builds up over time without proper attention, it leads to burnout which thankfully can usually be relieved by a longer span of time off—like a week vacation or holiday break. Compassion fatigue rests on the more intense end of the spectrum of the impact of caring for others. Sometimes known as “vicarious” or “secondary trauma,” it is the most extreme manifestation of stress resulting from exposure to those who are suffering. It is important to note that compassion fatigue may present after sustained exposure or after only a single event.

In my work providing professional development and support to other professionals in the fields of mental health, social work, medicine, foster care, juvenile justice, family interventions, and community social services I often encounter colleagues who are inclined to underestimate the severity of the effects of compassion fatigue.

sad boy

There is something so uniquely vulnerable about sitting with children and youth who are hurting, who are suffering.

The general stigma is, “that’s not really an actual thing, and even so, I’ve got it under control.” I know. I thought the same thing for years as I worked as a community mental health clinician in Los Angeles County. For five years I saw children and youth who all had histories of physical, sexual, and/or emotional abuse; exposure to community and gang violence; or had experience in the system as a foster child or in a juvenile corrections facility or sometimes all of the above. When I first learned about compassion fatigue—in depth and as an actual issue complete with symptomatology—I thought I was fine. I had it together. I used the phrase “self-care” frequently to qualify activities in which I engaged. I went to supervision. I debriefed with colleagues. I had it all under control.

But I didn’t.

As I moved through that first compassion fatigue training, I began to connect the dots of what I was experiencing. I completed a self-evaluation and found myself to be off the charts with compassion fatigue and burnout and in subzero territory with barely any restorative assets in sight. I was in dire straits.

hair ladyWhen compassion fatigue hits, we feel it across the landscape of our entire being: cognitive, relational, emotional, spiritual, physical, and behavioral. Just like any other ailment of the mind or body, the symptoms begin to interfere with our normal, everyday functioning. We begin to question not only the meaning of our work, but the existential angst spreads to every area of our lives. Compassion fatigue unchecked has the power to unravel us entirely, even rocking our foundation of our core beliefs. It’s serious. It’s real. It deserves our undivided attention.

Thankfully, there is hope. Like with so many other challenges in our lives, awareness and education are vital first steps. Understanding the pervasive scope of compassion fatigue, how we are personally at risk or affected, and what practical steps are necessary to recover and maintain wellness and to prevent future instances.

Most importantly, we need to be kind to ourselves, honoring the truth that it is not a result of our own short-comings that we may experience compassion fatigue. In fact, “The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water and not get wet,” (Remen, 1996).

water sitAfter awareness comes action. It is vital that as professionals we intentionally pursue our own wellness. If experiencing compassion fatigue, a season in personal therapy is strongly recommended to address personal and professional circumstances leading to the secondary traumatization. Additionally working through an assets inventory will help to identify specific areas of life that need a boost in self-care practices, people, and pampering. The process is unique for everyone but it is not optional. As Dr. Charles Figley—expert in the field and Director of the Tulane Traumatology Institute–asserts, “It is unethical to not attend to your self-care as a practitioner, because intentional self-care practice prevents harming those we serve.”

Professionally and personally this time of year is often ripe for stress, burnout, and compassion fatigue. While an in-depth training usually spans several hours of teaching, self-evaluations, discussion, and workshopping self-care plans, I couldn’t leave you without a few quick tips for self-care best practices!

Quick Tips for Self-Care Best Practices:

Helpful hint 1: DO spend time with non-traumatized people (this includes family and friends!) who replenish your empathy, joy, and compassion. – Going out with colleagues after work or at lunch is only replenishing if you instate a “No Talking about Work” rule and hold each other accountable!

Helpful hint 2: Set firm boundaries around the time and space you spend with those who deplete your energy, compassion, and nurturing…yes, even/especially when they are your family and friends. It is difficult, not impossible.

Helpful hint 3: If you feel you must spend time with people who deplete you, plan your visit outside of your home, office, or personal space—go to their home, a restaurant, coffee shop, other public venue. This allows you the freedom to leave on your own schedule, avoiding the awkwardness of guests overstaying their welcome in your space.

Helpful hint 4: Set a specific amount of time for your visit and let them know at the beginning that you’ll need to leave by X time. You don’t need to give an explanation for where or why you need to leave, and you don’t need to contrive elaborate fictions. It may sound something like, “Sure let’s grab coffee, I can meet at 1pm and will need to head out by 2pm.”

Self-Care Challenge: Before the stroke of midnight on December 31, 2015, I challenge you to engage in three (3) activities of at least 1 hour each that serve only you. Meaning, you are the only beneficiary of the activity—be it a massage, a walk along a favorite hiking trail, a small gift for yourself, watching the game with friends, getting a sitter for a night out, engaging in a creative/art outlet, or turning off your electronics and going to bed early—whatever resonates with you, do that thing, guilt-free, and practice radical acts of self-love and care.


aJennifer Alumbaugh, MS is a Licensed Marriage and Family Therapist providing clinical and professional development consultation services at Enrichment Training and Counseling Solutions. She practiced as a mental health clinician throughout Los Angeles County working with children, youth, and their families from 2007-2012. In Central Texas, Jennifer has worked as a Site Coordinator with Communities in Schools of The Heart of Texas at G.W. Carver Middle School; as an independent consultant and professional development trainer; and conference speaker. In 2016 Jennifer created an implemented a therapeutic creative writing program, Brave Young Voices, at Klaras Center for Families and at the Texas Juvenile Justice Department correctional campus at Mart, TX.  Jennifer has extensive experience working with adolescent and adult survivors of psychological and spiritual abuse, trauma (sexual violence, childhood trauma, interpersonal violence); and complex PTSD. These, along with grief and loss work are her areas of specialization.  She may be reached at: jennifer@enrichmenttcs.com or 254-405-2496.

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